早期肝细胞肝癌组织中乙酰肝素酶、b-FGF、CD34的表达与微血管密度的关系及其病理和临床意义

目的探讨乙酰肝素酶（Heparanase,Hpa）、碱性成纤维细胞生长因子（basic fibroblast growth factor,b-FGF）及CD34在慢性乙型肝炎（乙肝）到早期肝细胞肝癌（hepatocellular carcinoma,HCC）组织中的表达与微血管密度（microvascular density,MVD）的关系及其病理和临床意义。方法采用免疫组化EnVision法检测14例早期肝细胞肝癌（早期HCC组）、70例乙肝后肝硬化（乙肝后肝硬化组）、70例慢性乙肝（慢性乙肝组）和10例正常肝组织（正常对照组）中Hpa、b-FGF、CD34的表达水平。对各组肝组织中Hpa、b-FGF表达进行半定量计数,CD34阳性微血管进行MVD计数。对各组肝组织的病理特征进行分析。结果早期HCC组肝组织中Hpa阳性表达率为57.1%（8/14）,明显高于慢性乙肝组的20.0%（14/70）和乙肝后肝硬化组的28.6%（20/70）（P〈0.05）。早期HCC组肝组织中b-FGF（＋-＋＋）阳性表达率为85.7%（12/14）,明显高于慢性乙肝炎组的52.9%（37/70）和乙肝后肝硬化组的57.1%（40/70）（P〈0.05）。相关性分析结果显示：早期HCC组肝组织中,b-FGF表达与MVD值呈正相关（r=0.808,P〈0.01）,Hpa表达与MVD值呈正相关（r=0.645,P〈0.05）,b-FGF表达与Hpa表达亦呈正相关（r=0.629,P〈0.05）。病理检查结果示：早期HCC组肝组织中CD34呈广泛、窦隙状强阳性表达,而在慢性乙肝组及乙肝后肝硬化组肝组织中肝窦多为呈阴性。结论 Hpa、b-FGF、CD34在早期HCC中的阳性表达高于非肝癌组织,为早期HCC与非肝癌组织的鉴别诊断提供依据。

Clinicopathologic Significance of CD34,b-FGF and Heparanase Expression in Tissues of Early Heptocellular Carcinoma and Their Relationships with Microvascular Density

Objective To explore clinicopathological significance of CD34 b-FGF and Heparanase（Hpa） expressions in the tissues which from chronic hepatitis B（hepatitis B） and early heptocellular carcinoma（hepatic cellular carcinoma,HCC）and the their relationships of CD34 with microvascular density（MVD）.Methods There were 14 early hepatic cellular carcinoma cases（early HCC group）,70 chronic hepatitis B cases（chronic hepatitis B group）,70 liver cirrhosis cases（liver cirrhosis group） and 10 normal liver tissues cases（normal control group） and all tissues were stained with Hpa,b-FGF and CD34 by immunohistochemistry method,semi-quantitation of Hpa and b-FGF expression and Quantization of sinusoid-like vessels were performed and analyzed in conjunction with the pathological features of every group tissues.Results The positive expression rate of Hpa in early HCC group was 57.1%（8/14）,significantly higher than that of chronic hepatitis B group（20.0%,14/70） and liver cirrhosis group（28.6%,20/70）（P〈0.05）.The positive expression rate of b-FGF（＋-＋＋）in early HCC group was 85.7%（2/12）,significantly higher than that of chronic hepatitis B group（52.9%,37/70） and liver cirrhosis group（57.1%,40/70）（P〈0.05）.Correlation analysis results showed： in the early HCC group,b-FGF expression and MVD value was positively correlated（r=0.808,P〈0.01）,Hpa expression and MVD values were positively correlated（r=0.645,P〈0.05）,b-FGF expression and Hpa expression also positively correlated（r=0.629,P〈0.05）.Pathological examination：the early HCC group tissues showed diffuse CD34 expression,while CD34 was mostly negative in the ＂sinusoid＂ regions of chronic hepatitis B and liver cirrhosis groups.Conclusion The expressions of Hpa,b-FGF and CD34 were remarkably increased in early HCC group,so combined detection of the Hpa,b-FGF and CD34 may provide the basis for the differential diagnosis of early hepatic cellular carcinoma and benign lesion of liver.